Negative-strand RNA viruses may be divided into two categories, the nonsegmented RNA viruses, including Rhabdoviridae, Filoviridae and Paramyxoviridae, and the segmented RNA viruses, including Orthomyxoviridae, Bunyaviridae and Arenaviridae. These families of RNA viruses include the following important pathogens: parainfluenza viruses, mumps virus, measles, respiratory syncytial virus, vesicular stomatitis virus, rabies, and influenza virus, etc. These viruses share many similarities in genomic organization and structure. The genomes of negative strand RNA viruses consist of single-stranded RNA of negative polarity. The genomic RNA must be transcribed into mRNA to direct the synthesis of viral proteins in the host cell. The viral RNA-dependent RNA polymerase controls transcription and replication of the RNA genome, thus no DNA of viral origin is involved in viral replication.
Respiratory syncytial virus (RSV), a non-segmented, negative-strand RNA virus in the pneumovirus subfamily of Paramyxoviridae, is a widespread human pathogen accounting for over 1 million deaths per year worldwide (McIntosh and Chanock, 1990, in Virology, 2nd edition. Raven Press, Ltd. NY 1045-1072). While the majority of serious cases are children from developing countries, there are estimated to be 300,000 hospitalized cases per year in the United States (Zisson, 1993, Shamen Pharmaceuticals, Inc. Company Report). It is also believed that of childhood deaths from pneumonia caused by respiratory viral infections, 62% are due to RSV (Heilman, 1994 RFA: "Mechanism of RSV Vaccine Immunopotentiation" N.I.A.I.D., Bethesda, Md.).
Similar to other negative-strand RNA viruses, the RSV genomic RNA is transcribed and translated into specific mRNAs that are translated into viral proteins required for virus reproduction followed by replication of the genome. Such replication provides additional templates for transcription as well as genomic RNA for progeny virus (Collins et al. 1996 in Fields Virology, eds. Lippincott, Philadelphia, 3rd edition p. 1313-1351). The single stranded RNA genome of RSV codes for ten virus-specific proteins. The negative stranded genome is packaged in a nucleocapsid and is surrounded by a lipid envelope containing two glycoproteins. One is the fusion protein which facilitates entry of RSV into cells through host membrane and viral membrane fusion.
The approved treatment for RSV is aerosolized ribavirin (1-b-D-ribofuranosyl-1,2,3-triazole-3-carboxamide). Ribavirin is administered as an aerosol which is inhaled. Ribavirin therapy has several limitations including minimal efficacy in clinical use, the requirement of a tent around the patient, the potential to clog ventilating units, and the observation of some teratogenicity in animal models (Froelich, 1994 SPI Pharmaceuticals, Inc. Company Report, Pershing Division), significant side effects and high cost. Recently, another treatment has been approved for the treatment for RSV, RESPIGAM, a polyclonal antibody administered by injection.
RSV replicates in several alveolar cell types including macrophage and epithelial lineages (Panuska et al., 1992, Am. Rev. Resp. Dis. 145: 934-939). Accordingly, ribavirin is administered to RSV infected individuals by inhalation of an aerosol (Taber et al., 1983, Pediatrics 72:613-18; Hall et al., 1983, N. Eng. J. Med. 308:1443-7; Englund et al., 1994, J. Pediatrics 125:635-41.)
Activator-antisense complexes (termed therein "2-5A:AS") have been described previously (Torrence et al., 1993, WO 94/09129 by Torrence et al.). Although antisense oligonucleotides have been used as antiviral agents, e.g.: to inhibit HIV replication, see Zamecnik et al.; 1986; Goodchild et al., 1988; Letsinger et al., 1989; Balotta et al., 1993; to inhibit RSV infection, WO95/22553 by Kilkuskie et al., no examples of the successful use of activator-antisense complexes as an antiviral therapy have been reported.
The mechanism of action of activator-antisense complexes is different than the mechanism of action of other antisense oligonucleotides. The activator portion of the activator-antisense complexes activates RNase L and the antisense domain serves as a specific, high affinity binding site for the target RNA. The result is the selective cleavage of the target RNA by RNase L.
Physiologically, RNase L functions as part of the interferon system in restricting virus replication in cells of higher vertebrates (reviewed in Silverman, 1994). Interferon treatment of cells activates genes encoding 2-5A synthetases, double-stranded RNA (dsRNA)-dependent enzymes that produce 5'-triphosphorylated, 2',5'-linked oligoadenylates (2',5'A) from ATP. Viral dsRNAs are potential activators of these enzymes (Gribaudo et al., 1991). The 2',5'A binds to and activates RNase L resulting in the general cleavage of cellular and viral RNA; thus restricting the replication of some picornaviruses (Chebath et al., 1987; Rysiecki et al., 1989; and Hassel et al., 1994).
RNase L is not specific for cleaving viral RNA. For instance, in interferon-treated, encephalomyocarditis virus infected cells, RNase L causes degradation of ribosomal RNA (Wreschner et al., 1981, Nature 289: 414-417). Through the activator-antisense approach, RNase L is converted from a non-specific nuclease to a highly specific endoribonuclease that selectively cleaves mRNA targets. This has been demonstrated in a cell-free system from Daudi cells, a human lymphoblastoid cell line, in which a modified HIV-1 vif mRNA was targeted for cleavage by an activator-antisense complex (Torrence et al., 1993, Proc. Natl. Acad. Sci. 90:1300-1304). Subsequently, purified RNase L has been directed by an activator-antisense complex to cleave selectively an mRNA target encoding the protein kinase PKR in the presence of a nontargeted mRNA (Maran et al., 1994, Science 265: 789-792). Furthermore, in HeLa cells, the use of activator-antisense complexes, which were directed to a sequence in PKR mRNA, resulted in the ablation of PKR mRNA and enzyme activity (Maran et al., 1994, Science 265: 789-792) such that the dsRNA-mediated activation of transcription factor, NF-.kappa.B was ablated. More recently, it was shown that the activation of RNase L by an activator-antisense complex results in the catalytic degradation of PKR mRNA (k.sub.cat of about 7 sec.sup.-1) (Maitra et al., 1995 J. Biol. Chem. 270: 15071-15075).